Department of Orthopaedic Surgery, the First Affiliated Hospital of Guangzhou Medical College, 151 Yanjing Road, Guangzhou, China.
Spine (Phila Pa 1976). 2009 Aug 15;34(18):1887-92. doi: 10.1097/BRS.0b013e3181b0e579.
A histologic study of recombinant human bone morphogenetic protein-2/calcium phosphate cement (rhBMP-2/CPC) using adult rhesus monkeys in vivo.
To evaluate the histologic changes of rhBMP-2/CPC in vertebroplasty and determine the feasibility of this bone substitution instead of polymethylmethacrylate (PMMA).
Previous studies have shown that the new rhBMP-2/nanoscale CPC has a suitable strength and injection for vertebroplasty. However, the osteoinductive properties and biodegradable characteristics are still unclear.
Percutaneous vertebroplasty (PVP) was performed in 4 adult rhesus monkeys of 2 groups. Ten vertebral bodies (VBs) from T10-L7 of each rhesus were selected, and the 20 VBs in each group were randomly divided into 3 subgroups. Subgroup A (rhBMP-2/CPC): 8 VBs, filled with rhBMP-2/CPC; Subgroup B (PMMA): 6 VBs, filled with injectable PMMA; Subgroup C (control): 6 VBs, filled with normal saline. The 2 rhesus monkeys from each of the groups were killed at 2 and 6 months after operation, respectively. Individual specimens from the 40 VBs were collected for histologic observation.
In subgroup A, radiographic and histologic observations showed that the part of the rhBMP-2/CPC cement degraded with new bone and new vessel ingrowths, into the material, after 2 months. In addition, gaps, fibrous hyperplasia, or sclerotic callus were not found in the interface. After 6 months, the cement was nearly all replaced by mature bone tissue. In subgroup B, the inflammatory cell infiltration and fibrous membrane gapping were found after 2 months, and subsided partly at 6 months. But no new bone formation and material degradation were discovered. In subgroup C, the tunnels were filled with irregular new trabeculae after 2 months and unrecognizable from the surrounding mature bone after 6 months.
It is confirmed that the rhBMP-2/CPC is an osteoinductive and biodegradable material (in animal trials). It may also be an alternative to PMMA in order to achieve biostabilization in a vertebroplasty.
在体内使用成年恒河猴进行重组人骨形态发生蛋白-2/磷酸钙水泥（rhBMP-2/CPC）的组织学研究。
评估 rhBMP-2/CPC 在椎体成形术中的组织学变化，并确定这种骨替代物代替聚甲基丙烯酸甲酯（PMMA）的可行性。
先前的研究表明，新型 rhBMP-2/纳米磷酸钙水泥具有适合的强度和可注射性，用于椎体成形术。然而，其成骨诱导特性和生物降解特性仍不清楚。
对 2 组 4 只成年恒河猴进行经皮椎体成形术（PVP）。每只恒河猴的 T10-L7 选择 10 个椎体（VBs），每组的 20 个 VBs 随机分为 3 个亚组。亚组 A（rhBMP-2/CPC）：8 个 VBs，填充 rhBMP-2/CPC；亚组 B（PMMA）：6 个 VBs，填充可注射性 PMMA；亚组 C（对照组）：6 个 VBs，填充生理盐水。每组的 2 只恒河猴分别在术后 2 个月和 6 个月时处死，收集 40 个 VBs 的个体标本进行组织学观察。
在亚组 A 中，影像学和组织学观察显示，rhBMP-2/CPC 水泥的部分在 2 个月后降解，与新骨和新血管长入材料中，此外，在界面处未发现间隙、纤维增生或硬化性骨痂。6 个月后，水泥几乎全部被成熟的骨组织替代。在亚组 B 中，2 个月时发现炎症细胞浸润和纤维膜间隙，6 个月时部分消退。但是没有发现新骨形成和材料降解。在亚组 C 中，2 个月时隧道内填充不规则的新生小梁，6 个月后与周围成熟骨难以区分。
证实 rhBMP-2/CPC 是一种具有成骨诱导和生物降解能力的材料（在动物试验中）。它也可能是 PMMA 的替代品，以达到椎体成形术中的生物稳定。
